scholarly journals Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahimeh Ranjbar ◽  
Leila Allahqoli ◽  
Soheila Ahmadi ◽  
Robab Mousavi ◽  
Maryam Gharacheh ◽  
...  
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Health Care Services ◽  
Mode Of Delivery ◽  
Preterm Births ◽  
Future Health ◽  
Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

scholarly journals Clinical study showing a lower abundance of Neisseria in the oral microbiome aligns with low birth weight pregnancy outcomes

2021 ◽  
Author(s):  
Changchang Ye ◽  
Meng You ◽  
Ping Huang ◽  
Zhongyi Xia ◽  
Allan Radaic ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Periodontal Disease ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Oral Microbiome ◽  
Lower Abundance ◽  
Healthy Infants ◽  
Significant Difference ◽  
Abundance And Diversity

Abstract Objectives The objective of this study was to examine the association between the oral microbiome and pregnancy outcomes, specifically healthy or preterm low birth weight (PLBW) in individuals with and without periodontal disease (PD). Material and methods In this prospective clinical trial, we recruited 186 pregnant women, 17 of whom exhibited PD and delivered PLBW infants (PD-PLBW group). Of the remaining women, 155 presented PD and delivered healthy infants; 18 of these subjects with similar periodontal condition and age matched to the PD-PLBW group, and they became the PD-HD group. From the total group, 11 women exhibited healthy gingiva and had a healthy delivery (HD) and healthy infants (H-HD group), and 3 exhibited healthy gingiva and delivered PLBW infants (H-PLBW group). Periodontal parameters were recorded, and subgingival plaque and serum were collected during 26–28 gestational weeks. For the plaque samples, microbial abundance and diversity were accessed by 16S rRNA sequencing. Results Women with PD showed an enrichment in the genus Porphyromonas, Treponema, and Filifactor, whereas women with healthy gingiva showed an enrichment in Streptococcus, Actinomyces, and Corynebacterium, independently of the birth status. Although no significant difference was found in the beta diversity between the 4 groups, women that had PLBW infants presented a significantly lower abundance of the genus Neisseria, independently of PD status. Conclusion Lower levels of Neisseria align with preterm low birth weight in pregnant women, whereas a higher abundance of Treponema, Porphyromonas, Fretibacterium, and Filifactor and a lower abundance of Streptococcus may contribute to periodontal disease during pregnancy. Clinical relevance The oral commensal Neisseria have potential in the prediction of PLBW.

scholarly journals Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Serge Henri Zango ◽  
Moussa Lingani ◽  
Innocent Valea ◽  
Ouindpanga Sekou Samadoulougou ◽  
Biebo Bihoun ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
Burkina Faso ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Pregnancy Outcomes ◽  
Rural Setting ◽  
Sexually Transmitted ◽  
The Impact

Abstract Background Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. Methods Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. Results During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 – 1.07)], STIs [Adjusted OR: 0.74 (0.51 – 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 – 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 – 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 – 1.59)], curable STI [Adjusted OR: 1.65 (1.06 – 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 – 3.52)]. Conclusion Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.

scholarly journals Changes in the physiological parameters of newborns in the first one hour of life

2019 ◽  
Vol 6 (4) ◽  
pp. 1533
Author(s):  
Shasidhar Reddy Y. ◽  
Abdul Mohid Syed ◽  
Gangadhar B. Belavadi
Keyword(s):  
Heart Rate ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Oxygen Saturation ◽  
Mode Of Delivery ◽  
Physiological Parameters ◽  
Peripheral Oxygen Saturation ◽  
College Hospital ◽  
Significant Difference ◽  
The Mean

Background: The transition from a fetus to a newborn is the most complex adaptation that occurs in human experience. This study assessed three physiological parameters viz. temperature (core and peripheral), oxygen saturation and heart rate so as to avoid the delay in normal transitional adaptation.Methods: This cross-sectional observational study was done at Narayana Medical College Hospital, Nellore, Andhra Pradesh, India. A total of 150 neonates born from June 2017 to February 2018 were monitored for heart rate, oxygen saturation, core and peripheral temperature from birth to 60 minutes.Results: Most of the mother’s (45.33%) were aged between 22 to 25 years and the mean age was 23.75±3.64 years. History of consanguineous marriage was noted in 33.33%. The mode of delivery was vaginal in 70.67% of the babies. The mean gestational age was 38.74±1.36 weeks. The birth weight among 62% of the babies was between 2.5 to 3.49 Kgs and mean birth weight was 2.81±0.49 kgs. The meconium stained liquor and requirement of resuscitation was noted in 9.33% and 10.67% respectively.Conclusions: Significant difference was noted with regard to heart rate in babies with active resuscitation, low birth weight (<2.5 kg), meconium stained liquor and warmer care compared to normal babies. There was variation in oxygen saturation in babies who required resuscitation and warmer care, and those who had low birth weight. The mean peripheral and core temperature were different in babies with abdominal care compared to warmer care.

scholarly journals Pregnancy outcomes in sexually transmitted infections or human immunodeficiency viruses infected women at a tertiary care center: a retrospective study

2021 ◽  
Vol 7 (2) ◽  
pp. 229
Author(s):  
Saradha K. P. ◽  
Anitha Christy Stephen ◽  
Vikram V. Huddar
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Adverse Pregnancy Outcomes ◽  
Cd4 Count ◽  
Clinical Staging ◽  
Normal Delivery ◽  
Adverse Pregnancy

<p><strong>Background: </strong>The natural history of HIV infection in early disease is not affected by pregnancy. In later stages there may be rapid disease progression leading to adverse pregnancy outcomes. Prevalence of HIV in India is 0.3% in pregnant women. With the advent of PPTCT, there have been a decline in the adverse pregnancy outcomes but still few adversities are reported.  Aim of the study was to assess the various pregnancy outcomes in HIV positive women and the effects of antiretroviral therapy (ART).</p><p><strong>Methods: </strong>A retrospective analytical study conducted from July 2017-June 2019 on HIV infected pregnant women. Their maternal age, CD4 count at diagnosis of HIV, after postpartum, mode of delivery, birth weight and HIV status of baby were noted and analyzed.  <strong></strong></p><p><strong>Results: </strong>18 HIV infected pregnant women were included. Their mean age was 25.6 years. 12 patients were in 2<sup>nd</sup> trimester and the rest in 1<sup>st</sup> trimester. All were on triple-drug (TEL) regimen. Three were diagnosed with HIV prior to conception and were already on ART. Remaining were detected at the time of ANC visit. All cases fall under stage I WHO clinical staging. Out of the 18 pregnant, two delivered by LSCS and the rest by normal delivery. All were term deliveries, with mean birth weight of 2.82 kg. One HIV infected baby was born by LSCS. The mean CD4 count at the time of diagnosis of HIV was 389 and at postpartum was 508. Overall, there was seen to be an increase in CD4 count without any adverse effects during ART.<strong></strong></p><p><strong>Conclusions: </strong>Prompt HIV diagnosis and ART initiation during antenatal period can have good pregnancy outcome and thereby reducing transmission to children.</p>

scholarly journals Maternal urinary levels of trichloroacetic acid and association with adverse pregnancy outcomes

2019 ◽  
Vol 17 (6) ◽  
pp. 884-895 ◽  
Author(s):  
Funanani Mashau ◽  
Esper Jacobeth Ncube ◽  
Kuku Voyi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Premature Birth ◽  
Trichloroacetic Acid ◽  
Adverse Pregnancy Outcomes ◽  
Potential Health ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract The current study aimed to determine the association between trichloroacetic acid (TCAA) levels and adverse pregnancy outcomes among third-trimester pregnant women who were exposed to chlorinated drinking water. A total of 205 pregnant women who participated in the disinfection by-products exposure and adverse pregnancy outcome study in South Africa were randomly asked to participate in this study by providing their morning urine sample voids. Samples were analysed for urinary creatinine and TCAA. Furthermore, participants gave individual data using a structured questionnaire. The mean (median) concentration of creatinine-adjusted urinary TCAA was 2.34 (1.95) μg/g creatinine. Elevated levels of creatinine-adjusted TCAA concentrations showed an increased risk of premature birth, small for gestational age (SGA) and low birth weight. There was no significant statistical correlation observed between creatinine-adjusted TCAA concentrations and the total volume of cold water ingested among the study population. No statistically significant association was observed between creatinine-adjusted urinary TCAA and premature birth, SGA and low birth weight newborns among the study subjects. However, the urinary TCAA concentrations identified in this study suggest potential health risks towards women and foetus. Therefore, further studies are warranted to prevent further adverse pregnancy outcomes.

Antenatal Azithromycin to Prevent Preterm Birth in Pregnant women with Vaginal Cerclage. A Randomized Controlled Trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rania Hassan Mostafa ◽  
Sherif Ahmed Ashoush ◽  
Hassan Awwad Bayoumy ◽  
Wessam Kamal Lotfy Gabr
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Perinatal Morbidity ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Gestational Age At Delivery

Abstract Background Preterm birth with its complications is one of the leading causes of perinatal morbidity and mortality, as well as maternal morbidity, especially in low and middle-income countries. Cervical cerclage is a well-established preventive tool in women at high risk of preterm birth; however, subclinical maternal infection might still cause failure of this method. Thus, adding prophylactic antibiotics, namely macrolides, could prevent preterm birth. Patients and methods This was a randomized controlled clinical trial involving two groups of women who underwent vaginal cerclage at Ain Shams University Maternity Hospital. One group received azithromycin 500mg one tablet orally once daily for 3 days every month from 14th week to 34th week gestation, in addition to routine antenatal care; while the other group received usual antenatal care without antibiotic prophylaxis after cerclage. Follow-up was done and we compared the outcomes in each group: gestational age at delivery, birth weight, mode of delivery, maternal complications, and perinatal complications. ClinicalTrials.gov Identifier NCT04278937. Results Gestational age at delivery was significantly higher in the azithromycin group (36.8weeks vs 34.1weeks; P = 0.017), with significant prolongation of gestation in the azithromycin group (23.7weeks vs 21.1weeks; P = 0.005). As regards birth weight, it was significantly higher in the azithromycin group (2932.6gm vs 2401.8gm; P = 0.006); however babies with low birth weight (birth weight &lt;2500gm) were non-significantly less frequent in the azithromycin group (3cases vs 7cases; P = 0.165). There was no significant difference between the two groups as regards other outcomes (miscarriage, stillbirth, neonatal intensive care unit admission, antepartum hemorrhage, postpartum pyrexia, need for blood transfusion). Conclusion Adding azithromycin as antenatal prophylaxis in women undergoing vaginal cerclage prolongs pregnancy and reduces risk of PTB, with slight increase in birth weight. However, there was no clear effect on incidence of low birth weight, or perinatal morbidity/mortality.

scholarly journals Comparison between heater with incubator care in providing warmth to low birth weight newborns

2013 ◽  
Vol 2 (2) ◽  
pp. 4-8
Author(s):  
R Quddush ◽  
N Islam ◽  
MJ Hasan ◽  
M Rahman ◽  
J Rayen ◽  
...  
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Health Care Facilities ◽  
The Body ◽  
Care Group ◽  
Moderate Hypothermia ◽  
Significant Difference ◽  
Care Facilities ◽  
Incubator Care

Prevention of excessive heat loss is fundamental to survival of low birth weight (LBW) newborns. Highly expensive incubator is not available in most of the health care facilities of Bangladesh. Warm cot care by heater or with light bulbs may alternatively help in maintenance of temperature of LBW newborns in health care facilities where incubator is not available. So far i know no such study was conducted before in our country, this study was carried out to show the effectiveness of warm cot care in comparison to incubator care. The present study was cross sectional descriptive type study conducted in the Department of Neonatology, Mymensingh Medical College over a period 1 year from January 2009 to December 2009. Fifty neonates weighing 1200-2000g with gestational age ? 30 weeks to 40 weeks were allocated to an incubator group and similar number with same criteria were taken as cot care group. In cot care group, those babies were selected that are not supposed to cot care due to lack of incubator. The study showed that there were no differences between infants warm cot care versus incubator care. The temperature of the study patients showed that 34(68.0%) and 36(72.0%) maintained normal temperature all the time during hospital stay prior to discharge and rest 16(32.0%) and 14(28.0%) in cot and incubator group respectively became either hypothermic or hyperthermic. Mild hypothermia/cold stress was 7(14.0%) in cot and 4(8.0%) in incubator group. Moderate hypothermia and severe hypothermia was none in both groups. Hyperthermia/fever was 9(18.0%) and 10(20.0%) in cot and incubator group respectively. Analysis reveals that no significant difference was found between two groups. The body temperature of the low birth weight babies (weighing1200-2000g) can be satisfactorily maintained in the low-cost warm cots without the help of incubators which are costly and not available in most of the health care facilities in the developing countries like Bangladesh. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16691 Community Based Medical Journal 2013 July: Vol.02 No 02: 4-8

scholarly journals Comparative study of early neonatal outcome in low birth weight babies in hypertensive disorders complicating pregnancies with the mode of delivery

2021 ◽  
Vol 8 (3) ◽  
pp. 339-345
Author(s):  
Sivajyothi Pilli ◽  
Kavitha Bakshi
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Low Birth Weight ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Survival Advantage ◽  
Hypertensive Disorders ◽  
Significant Difference

Pregnancy induced Hypertension (PIH) is strongly associated with intrauterine fetal growth restriction (IUGR), low birth weight (LBW) and admission to NICU. PIH is not by itself an indication for caesarean delivery. However, the incidence of caesarean is high because of the development of complications in mother and the need to deliver prematurely. To compare the immediate morbidity and survival advantage of LBW vertex presenting babies with the mode of delivery in hypertensive disorders complicating pregnancies. This was a comparative cross-sectional study done on women admitted to the labour ward during the study period with PIH delivering a baby through either a vaginal delivery or a caesarean section with a birthweight of &#60;2.5kgs. A detailed history taking and clinical examination was done. Babies were followed up for one week following delivery to note down the early neonatal outcome. In this study, over all there was no statistically significant difference in neonatal outcome in both vaginal delivery and caesarean section groups. However, there was slight increased incidence of prematurity (68% vs 64%), Birth Asphyxia (14% vs 8%), Sepsis (8% vs 6%), IVH (6% vs 2%) and Hyperbilirubinemia (16% vs 14%) in vaginal delivery group. While, RDS (20% vs 14%) and NEC (4% vs 2%) had higher incidence in caesarean delivery group. Overall, prematurity and IUGR resulting in LBW, contributed to these neonatal complications. Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for LBW vertex presenting foetuses in PIH patients. Neonatal outcomes are not worsened by spontaneous or induced vaginal delivery in women with hypertension with good control and also decreases morbidity due to caesarean section to the mother.

scholarly journals The association between symptoms of depression during pregnancy and low birth weight:a prospective study

2020 ◽  
Author(s):  
Xiu xiu Li ◽  
Rui Gao ◽  
Xiaowei Dai ◽  
Hong Liu ◽  
Jinxin Zhang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
Antenatal Depression ◽  
Depression Symptoms ◽  
Antenatal Depressive Symptoms ◽  
Child Healthcare

Abstract Background Most studies have showed that maternal depression is associated with pregnancy complications. However, there were limited evidences in Chinese population. We examined the associations of antenatal depression symptoms with pregnancy outcomes, especially for low birth weight. Methods A total of 1377 singleton pregnant women were recruited from Nanshan Maternity & Child Healthcare Hospital of Shenzhen in this prospective cohort study. Depression symptoms were assessed by the Edinburgh postnatal depression scale (EPDS) questionnaire in the second trimester of gestation; cut-points for the indication of antenatal depression were ≧12 scores in this study. Socio-demographic data, life-style and pregnancy outcomes were collected through Shenzhen Maternity & Child Healthcare database. The risks of adverse outcomes in pregnant women with antenatal depression were determined by multivariate logistic regression and represented as odds ratio(OR) and 95% confidence interval (CI). Results Of the 1377 subjects, the prevalence of antenatal depression was 19.1%. The EPDS scores were 13.8±2.0 and 6.5±2.9 ( P <0.001) in subjects with and without antenatal depression, respectively. After adjustment for maternal age, education, parity, pre-pregnancy body mass index (BMI), residential area, fetal gender, an EPDS score≥12 (versus. <12) was associated with an increased risk for low birth weight(odds ratio: 2.05, 95% CI: 1.12-4.64), but not for preterm birth, large for gestational age, small for gestational age or macrosomia. Conclusion Pregnant women presenting antenatal depressive symptoms are at elevated risk of low birth weight. Mental health problems of pregnancy should be addressed for the prevention of low birth weight.

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